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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416147
Report Date: 01/21/2025
Date Signed: 01/21/2025 04:11:11 PM

Document Has Been Signed on 01/21/2025 04:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:SMILEY & ROSS FAMILY CHILD CAREFACILITY NUMBER:
197416147
ADMINISTRATOR/
DIRECTOR:		SMILEY & ROSSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 722-3891
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
01/21/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:03 PM
MET WITH:Kimberly RossTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On 1/21/2025, Licensing Program Analysts (LPAs) Carol Heath and Ana Rodriguez conducted an unannounced annual inspection at Smiley and Ross Family Child Care. Upon arrival, LPAs Heath and Rodriguez was greeted by the licensee, Kimberly Ross, who provided a facility tour. The home is occupied by 2 adults (the licensees and 1 daughter). No childcare children were present. According to Licensee no child care children are cared for in the home she only provide pickup and drop off. 2 Licensee grandchildren (ages: 1 and 4) were present during the inspection. The licensee stated that the facility operates Monday through Friday, 6:00 a.m. to 6:00 p.m. Incidental Medical Services (IMS) were discussed, and the licensee confirmed that no children currently require IMS.
The home is set up as follows:
This is a one–story house with 3 bedrooms, 2 bathrooms, one loft, a living room, a family room, a dining room/ kitchen, a laundry room area, and a garage. There is an in-ground pool on the premises. The home was inspected for safety, comfort, cleanliness, telephone service, and ventilation. It has central heating and air conditioning, and all windows have screens free of cracks, bugs, and debris.
Main Area: The living room, family room, and dining room are for childcare. Children can access the kitchen and backyard.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Ana Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SMILEY & ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147
VISIT DATE: 01/21/2025
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Dining Room: LPAs observed age-appropriate toys and furniture in the designated childcare areas. Cotton candy machine, pop corn machine, blackstone grill, and crockpot box observed in the gated dining room area. A window blind cord and the cables of the back of a dehydrator are accessible to children.
Children's Bathroom (#1): The children’s bathroom is down the hall to the right next to the dining room. LPA observed that the toilet and faucets are clean and operable. The medication cabinet is free of medications or personal items, and all poisons and medications are secured with child safety latches under the sink cabinet. The bathroom was found to be clear of any hazardous items.
Kitchen: The kitchen was inspected for safety, and it was noted that hazardous items are in reach of child care children. There were no child safety latches on any of the kitchen cabinets. Sharp utensils, poisons, and medications are inaccessible to children.
Backyard: The backyard was inspected. The children use the outside backyard for outside play. According to the Licensees daughter the children do not use the back yard due to weather conditions. The backyard is gated all around. There is no cover on the air conditioning unit. There is dog feces present in the dirt area of the back yard. A trampoline was present and accessible to children. Plants with sharp needles and thorns are present and accessible to children. Gardening tools (shovel and rakes) are present and accessible to children. There is a shed that does not have a lock. Hanging cables from the house are visible and accessible to children.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Ana Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SMILEY & ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147
VISIT DATE: 01/21/2025
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Off-limit: The front yard, bedroom #1-3, bathroom #2, backyard, laundry room and garage(key lock door knob) and are inaccessible to the day-care children.

Additional Information:

Bodies of water: LPAs observed an in-ground pool in the backyard. The wrought iron fences are constructed at least five (5) feet high. The bottom of the fence is no more than two (2). The fence does not obscure the pool from view. LPAs observed the gate near the home does not swing away from the pool. Self-close and self-latching device were not present. However, the faraway playground does have self-close and self-latching gate. LPAs did not observe life ring A life ring with or a rescue pole at the time of the visit. Daily inspection logs not present. Licensee did not receive AB 2866 swimming pool safety. LPA shared the information with Licensees daughter.


The Licensee does not provide meals. A required fire extinguisher (2A10BC) was observed in the kitchen. It is reading in the green zone, inaccessible to children, and meets standards established by the State Fire Marshal. The fireplace in the living room is screened and inaccessible to children. One window blind cord was not secured and accessible to children.
The household has four small dogs (kept in kennel), no proof of current vaccinations were observed. The home has a working cell phone. All smoke detectors and carbon monoxide devices were tested and found to be operable. A fully stocked first aid kit, including a first aid manual, and is inaccessible to children. The licensee does provide transportation for the children. They possess a valid California driver's license, vehicle insurance, and vehicle registration. Per the licensee, there are no firearms at the facility. LPA did not observe any firearms.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Ana Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SMILEY & ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147
VISIT DATE: 01/21/2025
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Documentation Review:

Child Files: LPA reviewed 2 children's records. The files contain all necessary licensing documents with parents’ signatures.

Immunization Records: The licensee have up-to-date immunizations for MMR and DTaP, and has the influenza vaccine.

CPR/First Aid: Licensee was unable to provide the Pediatric CPR and First Aid certifications


Mandated Reporter Training: The licensee and her assistant completed the online mandated reporter training at www.mandatedreporterca.com
Facility Fees: According to the Licensing Information System, the annual facility fees are current.
Fire/Disaster Drill: The licensee conducts fire and disaster drills every six months, with the last drill documented on 01/2025.
Required Postings: LPA observed that the licensee does have the Facility License, Emergency Disaster Plan, Earthquake Preparedness, and Parents' Rights Poster displayed as required.
The following information was discussed with the licensee:
o A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code sections 1596.848(b) and (c). State law prohibits baby walkers, bouncy seats, exersaucer, and other items that fall into that category.
o The licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Ana Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SMILEY & ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147
VISIT DATE: 01/21/2025
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oLicensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations. Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility's phone number; if the phone number is changed, licensing must be notified.
o Requirements for fire drills, earthquake drills, and documentation for both.
o The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 a.m. - 5:00 p.m.
o The licensee is reminded that 100% supervision is always required for children.
o The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, contact the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
o The regulation prohibits tobacco smoking in private residences that are licensed as family childcare homes and in those areas of the family childcare home where children are present (24/7 ban).
ü LPA discussed the safe sleep regulations with the licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and- resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Ana Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SMILEY & ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147
VISIT DATE: 01/21/2025
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üLicensee [or facility representative] was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
üIF THERE IS NO CHILD AT THE FACILITY THAT CURRENTLY NEEDS IMS, USE AS FOLLOWS: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
üCenters and Family Child Care Homes Licensee [or facility representative] was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
üFamily Child Care Homes During the exit interview, the LICENSEE ****, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
üFamily Child Care Homes A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Ana Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: SMILEY & ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147
VISIT DATE: 01/21/2025
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üTo improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-carelicensing/ inspection-process.
Deficiencies cited: (See LIC 809D). The following Type B deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes:
An exit interview was conducted, and the report was reviewed with the licensee Kimberly Ross.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Ana Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
Page: 7 of 11
Document is an Amendment of Original Document on 01/31/2025 09:49 AM


Created By: Carol Heath On 01/21/2025 at 03:22 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SMILEY & ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(1)(A)(i)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (1) The swimming pool shall be equipped with, at minimum, the following drowning prevention safety features: (A) An enclosure, including, but not limited to, a fence, wall, or other barrier that isolates the swimming pool from access to the family daycare home and has all of the following characteristics: (i) An access gate that opens away from the swimming pool and is self-closing with a self-latching, key lockable device placed no lower than 60 inches above the ground.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above. The Licensee did not have a self closing and self latching on pool gate which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/21/2025
Plan of Correction
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After talked to LPM, the sliding gate near the house backyard met Title 22 regulation.
Type B
Section Cited
HSC
1596.814(a)(1)(B)(ii)(I)
Pool Safety
(ii) (I) An alarm that, when placed in a swimming pool, will sound upon detecting an entrance into the water. The alarm shall be turned on and be in working condition during a facility’s operating hours while the swimming pool is not in use.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
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Based on observation, the licensee did not comply with the section cited above. LPAs do not observate the alarm in the pool,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/31/2025
Plan of Correction
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2
3
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The licensee will purches the pool alarm and email the pictures to the LPA
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 01/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/21/2025


LIC809 (FAS) - (06/04)
Page: 8 of 11
Document Has Been Signed on 01/21/2025 04:11 PM - It Cannot Be Edited


Created By: Ana Rodriguez On 01/21/2025 at 03:22 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SMILEY & ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(2)(A)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (2) The licensee shall have the following safety equipment visible from the swimming pool and readily available for immediate use: (A) A life ring with a minimum exterior diameter of 17 inches and labeled as approved by the United States Coast Guard.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above licensee does not have a life ring, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/07/2025
Plan of Correction
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The licensee will purchase a life ring and send the picture to the LPA
Type B
Section Cited
HSC
1596.814(a)(2)(B)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (2) The licensee shall have the following safety equipment visible from the swimming pool and readily available for immediate use: (B) A rescue pole with a body hook and a minimum fixed length of 12 feet.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above. The licensee does not have a rescue pole with a body hook. which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/07/2025
Plan of Correction
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2
3
4
The licensee will purchase a rescue pole with a body hook and email to LPA.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Ana Rodriguez
LICENSING EVALUATOR SIGNATURE:
DATE: 01/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/21/2025


LIC809 (FAS) - (06/04)
Page: 9 of 11
Document Has Been Signed on 01/21/2025 04:11 PM - It Cannot Be Edited


Created By: Ana Rodriguez On 01/21/2025 at 03:22 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SMILEY & ROSS FAMILY CHILD CARE
FACILITY NUMBER: 197416147

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.814(a)(3)
Pool Safety
(a) A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements: (3) A licensee shall perform a daily inspection of the drowning prevention safety features and safety equipment before opening the facility and maintain a log of the inspections to be provided to the department upon request.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above. The licensee does not have a daily inspection log, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/24/2025
Plan of Correction
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2
3
4
The licensee will sent a daily log for LPA to review by 11/24/2025
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above. The licensee was unable to provide her current CPR/First Aid,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/24/2025
Plan of Correction
1
2
3
4
The licensee will find her CPR and First aid and submit to LPA
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Ana Rodriguez
LICENSING EVALUATOR SIGNATURE:
DATE: 01/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/21/2025


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